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https://hdl.handle.net/2440/134529
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Type: | Journal article |
Title: | N-terminal B-type natriuretic peptide and the association with left ventricular diastolic function in a population at high risk of incident heart failure: Results of the SCReening Evaluation of the Evolution of New-Heart Failure Study (SCREEN-HF) |
Author: | McGrady, M. Reid, C.M. Shiel, L. Wolfe, R. Boffa, U. Liew, D. Campbell, D.J. Prior, D. Krum, H. |
Citation: | European Journal of Heart Failure, 2013; 15(5):573-580 |
Publisher: | Wiley |
Issue Date: | 2013 |
ISSN: | 1388-9842 1879-0844 |
Statement of Responsibility: | Michele McGrady, Christopher M. Reid, Louise Shiel, Rory Wolfe, Umberto Boffa, Danny Liew, Duncan J. Campbell, David Prior, and Henry Krum |
Abstract: | Aims: Impaired diastolic function is associated with increased morbidity and mortality, but antecedents and predictors of progression to heart failure (HF) are not well understood. We examined associations between NT-proBNP, HF risk factors, and diastolic function in a population at high risk for incident HF. Methods and results: A total of 3550 subjects at high risk for incident HF (≥60 years plus ≥1 HF risk factor), but without pre-existing HF or LV dysfunction were recruited. Participants at highest risk (n ¼ 664) (NT-proBNP in the highest quintile .254 pg/mL) underwent echocardiography. Moderate or severe diastolic dysfunction was observed in 25% [95% confidence interval (CI) 21–29%] of participants. Age (P ¼ 0.001), male gender (P ¼ 0.03), diabetes (P ¼ 0.03), and NT-proBNP (P ¼ 0.002) were associated with severity of diastolic dysfunction after adjustment for HF risk factors and LVEF. In regression analysis, log-transformed NT-proBNP was also associated with LV mass index (P ¼ 0.05), left atrial size (P , 0.0001), and Doppler ratio of the mitral valve E/e’ (P ¼ 0.001). Multiple HF risk factors were present in the majority of participants (.70%), but no association was observed between diastolic dysfunction and the number of risk factors reported (P ¼ 0.3). Conclusion: Diastolic dysfunction was observed in one in four of these high risk subjects (≥ 60 years, HF risk factor, NT-proBNP .254 pg/mL). NT-proBNP, age and diabetes were strongly associated with severity of diastolic dysfunction, whereas other HF risk factors and LVEF were not. More targeted surveillance using a combination of risk factors and biomarkers may improve identification of those at great risk of incident HF. |
Keywords: | Diastolic dysfunction; Echocardiography; Cardiac biomarker |
Rights: | © The Author 2013. For permissions please email: journals.permissions@oup.com. |
DOI: | 10.1093/eurjhf/hft001 |
Grant ID: | NHMRC |
Published version: | http://dx.doi.org/10.1093/eurjhf/hft001 |
Appears in Collections: | Medicine publications |
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